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What is ptosis

eyePtosis, as the name suggests, is a condition in which the eyelids droop, making it difficult to see. The eyelid protects the eyeball, moistens the surface of the eye when blinking, secretes tear components, etc., but it is the muscle tissue around the eyelid that moves the eyelid. For some reason, this function deteriorates, and if the pupil, which is the center of the pupil, is hidden, the field of vision will be blocked and it will be difficult to see. In order to lift the obstructive eyelids with the forehead, deep wrinkles are carved on the forehead, which may cause symptoms such as headaches. In addition, if the eyelids do not rise, the patient will be in a position to raise the chin and try to look up, causing symptoms such as stiff shoulders and neck. Since these are performed unconsciously, it is often the case that unexplained headaches and stiff shoulders are actually caused by ptosis.

Types of ptosis

Blepharoptosis can be congenital or acquired. Congenital ptosis can be an underdevelopment of the musculature within the eyelids or a problem with the shape of the eye you were born with. Acquired is aponeurotic ptosis, in which the muscle that lifts the eyelid (levator palpebrae superioris muscle) is separated from the eyelid, and eyelid skin that is difficult to see because the eyelid skin that has been stretched due to aging is heavy and covers the eye. There is flaccidity, and a combination of both. If it develops suddenly, it is better to consult a neurologist as soon as possible because a problem with the nerves or brain is suspected.

Causes of drooping eyelids

eyeThere are many different causes of drooping eyelids. If it is congenital, the cause is obvious, but if it is acquired, the person's predisposition, environmental factors, and lifestyle habits are involved in the onset, and the degree of occurrence varies on a case-by-case basis. Aponeurotic ptosis is known to be caused by mechanical irritation to the eyelids. For example, wearing hard contact lenses is famous. In addition, there have been reports of side effects of glaucoma eye drops, such as a history of intraocular surgery or trauma, frequent eye rubbing due to allergies or dry eyes, etc.

How to treat ptosis

For the treatment of blepharoptosis, we first exclude or treat internal diseases, and if the symptoms seem to be fixed, surgical treatment is considered. Surgery can be done on a day trip under local anesthesia unless it is a small child. There are many types of surgery, from surgery that does not cut the skin, to surgery that removes a large amount of skin, and grafting of tendons and artificial materials. The surgical procedure that suits each individual is determined based on the degree of ptosis, excess skin condition, and function of the levator muscle. In severe cases, multiple treatments may be required.

Flow of blepharoptosis treatment

First of all, you will receive counseling to diagnose whether the symptoms you are having trouble with are due to ptosis and whether the ptosis is the target of treatment. If ptosis is diagnosed, a simulation of surgery will be performed. For those who wish to have surgery, blood will be drawn to distinguish systemic diseases that cause ptosis. We will let you know the results of the blood test in about two weeks. If there is no abnormality in blood sampling, we will decide the date of surgery.

Insurance coverage for drooping eyelids

If blepharoptosis is diagnosed, surgery is covered by insurance. What is the difference between blepharoptosis surgery covered by insurance and cosmetic surgery performed by cosmetic surgery? That is, while blepharoptosis surgery performed by insurance aims to improve visual function and improve various symptoms caused by ptosis, cosmetic surgery is surgery performed to improve appearance. In blepharoptosis surgery covered by insurance, the appearance is secondary, so we cannot accept orders for the surgical method or double width. Therefore, people who are particular about their appearance may recommend cosmetic surgery.

Cases not diagnosed as ptosis

eyeIn order to be diagnosed with ptosis, it is necessary to meet the diagnostic criteria for ptosis. The distance from the edge of the upper eyelid to the center of the iris (pupil) is called MRD1 (Margin reflex distance), and if it is less than 2 mm, ptosis is diagnosed. In addition, as a criterion for whether or not to undergo surgery, our hospital emphasizes whether symptoms such as difficulty in seeing upwards, headaches, and stiff shoulders are caused by drooping eyelids.

Cases of blepharoptosis


by hard contact lensesptosis

Aponeurotic ptosis with laterality is a typical example of hard contact lenses.


due to facial paralysisptosis

She has post-herpetic facial nerve palsy, and her left eyelid droops heavily.


due to agingeyelid laxity

As we age, the skin on our forehead stretches and our eyebrows droop.

Frequently Asked Questions About Ptosis


I had a double surgery in cosmetic surgery before, but it came off a long time ago. Can I have surgery covered by insurance?


I think the general interpretation is that if you have had surgery at your own expense, even once, you cannot have surgery covered by insurance. I agree with that, but I don't judge whether surgery is suitable for you based on the degree of ptosis and the symptoms you are having trouble with. Also, please do not make any false declarations as you will be able to know your past surgery history after surgery.


Can ptosis recur after blepharoptosis surgery?


Since blepharoptosis is partly due to aging, it is possible that it will recur with age. If the cause is hard contact lenses, switching to soft contact lenses can prevent recurrence to some extent. If it recurs, it is possible to perform the operation again, but if the operation is performed on the same place, there is adhesion of the wound, etc., and the operation may become difficult and the swelling may be prolonged.


I'm worried because I heard that a celebrity had a failed surgery...


As a surgeon, what I try to do is to choose a technique that gives the most natural finish possible. If you do not make a mistake in the surgical procedure, you will eventually get a natural finish, but during the downtime after the surgery, the bleeding will inevitably become a hematoma and the eyelids will swell. The wound is also red for about half a year. In addition, the scars will remain inconspicuous, but they will remain for the rest of your life.

Video explanation! Flow of blepharoptosis surgery

At Motomachi Marine Ophthalmology, we perform one-day surgery for ptosis. For those who are in trouble but can't decide to undergo surgery or are worried about surgery, we have created a guide that explains the flow of surgery so that you can undergo surgery with peace of mind.

0:00 Introduction

0:31 Today's topic

0:53 Ptosis Symptoms and Counseling

1:57 Blood sampling and surgery appointment

2:47 Notes on the day

4:19 Postoperative Precautions and Expectations

The ​ blog introduces cases of blepharoptosis surgery performed at our hospital. If you are considering surgery but are worried about postoperative swelling or the finish, please take a look. *All photos are published with the consent of the patient. Thank you for your cooperation!

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